Active NPI
Kambria Bangma
- Behavior Technician
- Holland, MI
National Provider Identifier
1255917787
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 11172 Adams St
Holland, MI 49423-9163 - Phone
- (616) 301-8000
- NPI assigned
- Mar 23, 2021
- Last updated
- Mar 26, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | NU | Primary |
Addresses
Primary practice location
11172 Adams St
Holland, MI 49423-9163
Mailing address
11172 Adams St
Holland, MI 49423-9163
Phone (616) 301-8000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 949017840-00 | Other | PRIORITY HEALTH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1616457600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1616716800000",
"number": "1255917787",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11172 ADAMS ST",
"city": "HOLLAND",
"state": "MI",
"postal_code": "494239163",
"telephone_number": "616-301-8000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11172 ADAMS ST",
"city": "HOLLAND",
"state": "MI",
"postal_code": "494239163",
"telephone_number": "616-301-8000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BANGMA",
"first_name": "KAMBRIA",
"name_prefix": "Miss",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-03-23",
"last_updated": "2021-03-26",
"certification_date": "2021-03-26",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PRIORITY HEALTH",
"identifier": "949017840-00",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Holland, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.